Clipping of news on Brazilian Culture, Law and Citizenship
11/04/2013
This article was translated by an automatic translation system, and was therefore not reviewed by people.
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Brazil Agency reporter
Brasilia - It is common beneficiaries of health plans spend years paying high fees and the need to use the services , they are not assisted or realize an adjustment abusive tuition . To avoid inconvenience is necessary to pay attention to the contract and know a little more about the options that health insurance plans offer .
If on one hand the collective health plans hired by companies , trade unions and its employees and affiliates , are the first tuition cheaper , secondly they usually have an annual adjustment greater than individual plans . That's because the plan does not have a maximum rate adjustment determined by the National Health Agency (ANS) , the body that regulates the industry . Meanwhile, individual health plans , directly hired by the beneficiary , get more expensive , but the adjustments are regulated by the ANS .
Health plans can be adjusted in two ways : an annual adjustment , the anniversary date of the contract , and another adjustment for change in age . Ideally, the prospective beneficiary ask the company selling the health plan of monthly values of all age groups . Thus the citizen can choose what fits best in your household budget. The first adjustment due to change in age is age 19 . After 20 years , every five years the contractor has adjusted its plan , which will take place until 59 years of age .
According to the Brazilian Institute for Consumer Defense ( IDEC ) , the market for health plans are selling fewer individual plans . Most markets are called collective , because they have no adjustment and adjustable , one year contract , they can be terminated without cause by the operator .
Idec warns that the market is the practice of offering group plans by methods considered " aggressive " as pamphlets and other advertising tactics ostentatious , usually linked to the associations that consumers do not even know . In some cases , the contractor is invited to participate in trade associations which is not part of , eg , trade association or association of hairdressers , just to be able to adhere to the collective .
The institute advises against this type of contract , since there is no way to guarantee the suitability of the association intermediate contract . The institute's lawyer and expert in the field , Joan Cross , warned that the plans of up to 30 recipients " may be a trap ."
To hire a plan , the client must also set the type of service that most interests you . It is advisable , for example , consider only consultations and examinations meet consumer expectations or if it fits into your budget one that includes admissions , since in this case the package is more expensive . The types of stay , room or ward , and the area of coverage - local, state or national - are options that also have an impact on the consumer's pocket .
To have a lower monthly customer can opt for a plan with co-participation , but should remember that whenever you use a procedure will need to pay a percentage to the operator .
An assessment to be made by women contractors is if they need a plan with obstetric coverage . If the hire , the plan is required to pay the cost of delivery - normal or Caesarean - and to ensure coverage of newborns for 30 days . Also, if within that period the baby is included in the plan , it does not have any kind of grace .
It is also important to ask for the registration number of the carrier and check on the status of the company ANS . Every plan must offer the minimum coverage required by the agency determined according to each plan - ambulatory and hospital care with or without obstetrics, reference or dental - in addition to other procedures in the contract .
The NSA warns that the contractor shall notify if you have any health problem to the operator to adhere to a plan . The company will provide a statement of health and may appoint a physician to monitor the filling without any cost to the prospective beneficiary . The company may also request the client to medical expertise , also paid by the carrier . The ANS warning that the company may not charge any fee to join the plan , it can only charge the amount of tuition .
In no event shall the carrier may refuse a client, but if the consumer has any disease before hiring the company can offer as an alternative to suspension for up to two years of service for some procedures related to the disease, called grace . The company can also make an increase in the monthly payment to the beneficiary is entitled to all services , including those related to pre-existing disease . It will be up to the consumer to choose which prefer .
Source : Agency Brazil
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This article was translated by an automatic translation system, and was therefore not reviewed by people.